Patients’ experience and perceptions of polypharmacy in chronic kidney disease and its impact on adherent behaviour

SUMMARYAims To explore attitudes towards medicines, polypharmacy and adherence in patients with chronic kidney disease (CKD). Background Polypharmacy is common in CKD and associated with medication non-adherence. Methods As part of a mixed methodology project, a purposive sample of ten participants were recruited and interviewed to explore attitudes to medicines and reasons for adherent and non-adherent behaviour. Results Several reasons for non-adherence were reported. Interviewees described a variety of attitudes towards medicines. Complex medicine regimes were a frequently cited contributing factor in poor adherence. Concerns about or experience of side effects had a negative impact on adherence. Prioritisation of medicines was evident and the importance of communication with health professionals was a consistent theme. Conclusions Non-adherence with prescribed medicines in CKD is a complex phenomenon, which has implications for clinical outcomes and cost. Adherent behaviour may change over time. Further research in this field is needed. No single intervention is likely to enhance adherence for all and clinicians should consider a variety of options to improve adherence with prescribed medicines.